INITIAL COMMENTS
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This report is a result of an on-site licensure renewal inspection conducted on February 21, 2024 by staff from the Department of Drug and Alcohol Programs, Bureau of Program Licensure. Based on the findings of the on-site inspection, Renew Family Services, LLC was found not to be in compliance with the applicable chapters of 28 PA Code which pertain to the facility. The following deficiencies were identified during this inspection:
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Plan of Correction
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704.11(c)(1) LICENSURE Mandatory Communicable Disease Training
704.11. Staff development program.
(c) General training requirements.
(1) Staff persons and volunteers shall receive a minimum of 6 hours of HIV/AIDS and at least 4 hours of tuberculosis, sexually transmitted diseases and other health related topics training using a Department approved curriculum. Counselors and counselor assistants shall complete the training within the first year of employment. All other staff shall complete the training within the first 2 years of employment.
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Observations
Based on a review of personnel records, the facility failed to ensure that all staff received at least 4 hours of tuberculosis, sexually transmitted diseases, and other health related topics training, within the regulatory time frame, in one of one applicable personnel record reviewed.
Employee #4 was hired as a counselor on May 1, 2022. The TB/STD training was due no later than May 1, 2023; however, the training was not completed as of the date of the inspection.
This finding was discussed with facility staff during the licensing process.
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Plan of Correction
Renew Family Services will put into place a staff file review at the six month point prior to the end of the training year and 30 days prior to the end of the training year. This protocol will be that a identified person within the office will review the training of the staff. The staff will be made aware of how many training hours they currently have, how many are needed, and if any mandatory trainings are outstanding. This will also be discussed again during annual reviews and creating of any training plans made with staff. Current staff member that was mentioned in the inspection (employee #4 ) obtained the training through DDAP on 2-27-24. Certificate was printed and placed in his file. |
704.11(f)(2) LICENSURE Trng Hours Req-Coun
704.11. Staff development program.
(f) Training requirements for counselors.
(2) Each counselor shall complete at least 25 clock hours of training annually in areas such as:
(i) Client recordkeeping.
(ii) Confidentiality.
(iii) Pharmacology.
(iv) Treatment planning.
(v) Counseling techniques.
(vi) Drug and alcohol assessment.
(vii) Codependency.
(viii) Adult Children of Alcoholics (ACOA) issues.
(ix) Disease of addiction.
(x) Aftercare planning.
(xi) Principles of Alcoholics Anonymous and Narcotics Anonymous.
(xii) Ethics.
(xiii) Substance abuse trends.
(xiv) Interaction of addiction and mental illness.
(xv) Cultural awareness.
(xvi) Sexual harassment.
(xvii) Developmental psychology.
(xviii) Relapse prevention.
(3) If a counselor has been designated as lead counselor supervising other counselors, the training shall include courses appropriate to the functions of this position and a Department approved core curriculum or comparable training in supervision.
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Observations
Based on a review of personnel records, the facility failed to ensure each counselor completed at least 25 hours of training annually during the facility's January 2023 through December 2023 training year in one of three applicable personnel records reviewed.
Employee #3 was hired as a counselor on August 1, 2021. The personnel training record documented 4 hours of annual training for the training year reviewed.
These finding was reviewed with facility staff during the licensing process.
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Plan of Correction
Renew Family Services will put into place a staff file review at the six month point prior to the end of the training year and 30 days prior to the end of the training year. This protocol will be that a identified person within the office will review the training of the staff. The staff will be made aware of how many training hours they currently have, how many are needed, and if any mandatory trainings are outstanding. This will also be discussed again during annual reviews and creating of any training plans made with staff.
Renew Family Services will also look into brining in trainings for the 2024 training year to help assist staff in getting the training hours needed since half could be considered in house trainings. This will also be discussed in the overall training plan for the office. |